NPI | 1023419777 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CCMH0208691) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 70309) |
Enumeration Date | 2014-09-12 |
Last Update Date | 2024-04-20 |